what do pharmacists do?

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RonaldColeman

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Hey, guys, serious question here. This is not a flame, but an honest query from an interested medical student. What does being a pharmacist entail? Medical doctors write prescriptions for medications, which includes dosages, durations, etc. Any time I go to the pharmacist, it just seems like he fills the prescription according to the script and that's it. I'm sure I'm missing something. What is the pharmacist's role in this process? (Let me reiterate: this is not a flame, but a genuine question.)

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In the setting you are describing, retail, they assess whether the prescription order is appropriate, that you get what was ordered (if the order was appropriate), and counsel you to ensure that you can use the prescribed medication appropriately, effectively, and safely.
 
bananaface said:
In the setting you are describing, retail, they assess whether the prescription order is appropriate, that you get what was ordered (if the order was appropriate), and counsel you to ensure that you can use the prescribed medication appropriately, effectively, and safely.

Google "drug-related problems" and "pharmaceutical care". Basically pharmacists cover the physicians' butts.
 
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bananaface said:
In the setting you are describing, retail, they assess whether the prescription order is appropriate, that you get what was ordered (if the order was appropriate), and counsel you to ensure that you can use the prescribed medication appropriately, effectively, and safely.

In addition, they may also advice a patient on what medications to take otc, answer simple medical question such as medical procedures, help manage chronic problems like diabetes, compound medications, survelliance for any conditions that should be reported to CDC and so on.

However in a retail setting, their main job is to make sure the prescription is okay before filling and answer questions that a customer might have. Its also their job to make sure that the right medication goes out to the right customer; quality control. Nothing too important by your standards. Do keep in mind that for most people, they go see their pharmacist first (you can talk to us asap and its free) before going to see a doctor (long waiting time and they might have to pay out of pocket) when they have a problem. Also there is a pharmacy every block.

A clinical pharmacist is a whole different story though.
 
When you get patients with chronic health conditions, they see more than one physician. The patients don't always give their current drug information to the new physician. Then he/she can prescribe a medication that absolutely should not be taken with another medication prescribed by someone else. Sometimes they aren't contraindicated, but can still cause a problem.

There are patients who are diabetic and see an endocrinologist. Suppose they prescribe an ACE inhibitor for kidney protection, but the patient's primary already has them on two other HTN medications? Now the patient gets orthostatic hypotension, falls and breaks a hip.

A pharmacist has access to the patient's medication history and prevent these things happening.

It isn't all just catching the errors, though there are plenty of those. Physicians get busy and don't necessarily check the patient's allergies before prescribing. This happens a lot with sulfa antibiotics.

Again, this is just in retail pharmacy. There are many other areas of pharmacy. I'll be on a critical care rotation in 6 weeks. We have to dose drugs for patients with end stage renal disease or hepatic failure.
 
A Pharmacist in community checks the prescription that the technician enters, checks to make sure the drug is correct for what is needed, checks the dose based on weight especially in peds, checks the directions, answers tons of questions regarding OTC medications and also other questions related to medical advice. Pts come in and show their rashes and their lice and everything to the pharmacist. Pharmacist in community give out a lot of advice. they also counsel on new prescriptions for patients. Like should they take with food or no food, will this make them go to the bathroom more. stuff that may not have been covered by a physician.

A hospital pharmacist does similar things to community as far as order entry, however they do not have much patient contact so they usually just make recommendations to the physicians or medical residents.

A Clinical pharmacist can work inpatient with physicians. The inpatient pharmacist goes on rounds with a "medical team" that will include med students, med residents, and an attending. The pharmacist checks all meds on the lists for interactions, and appropriateness. The pharmacists makes recommendations to the team. The pharmacist also discharge counsels the pateints on their medications and makes sure the patient goes home on the same meds they came in on especially b/c of problems with formulary changes.

A Clinical pharmacist in outpt can have their own "doctor's office". Pts schedule appts with the pharmacist especially for chronic diseases.
This is in collaboration with a physicina.
They can also work with physicians and nurses and residents and all see the patient together.
Again in this setting the pharmacist makes sure all drugs are appropriate and that they are dosed correctly. Pharmacist recommends increases in doses, etc. The pharmacist also counsels patients on disease and lifestyle modifications

A pharmacist can also work in the business setting and help with formularies drugs and can work in marketing based on drug knowledge and help with the development of sales reps
 
RonaldColeman said:
Hey, guys, serious question here. This is not a flame, but an honest query from an interested medical student. What does being a pharmacist entail? Medical doctors write prescriptions for medications, which includes dosages, durations, etc. Any time I go to the pharmacist, it just seems like he fills the prescription according to the script and that's it. I'm sure I'm missing something. What is the pharmacist's role in this process? (Let me reiterate: this is not a flame, but a genuine question.)

Ok..a serious response. I'm going to make an assumption (which may be wrong...) that you are a relatively young, healthy man who doesn't have many chronic medical issues. When you bring in that prescription for the antibiotic, pain med, etc...yeah - its pretty easy..we check for drug interactions, review your allergies, review the Rx to make sure its appropriate (if you indicate you have an infection, but the writing looks like Keppra rather than Keflex, we clarify; make sure the dose & duration is appropriate) make sure you get the right stuff, know how to use it & answer any questions. But, as you might have already found out..young, otherwise healthy patients are not the difficult ones. Now, if you had COPD, CHF, diabetes, arthritis, depression, and prostate problems (a huge % of retail patients) you'd be seeing multiple physicians, taking lots of chronic medications, and have lots of issues that would impact drug therapy (good chance of some degree of renal failure and a huge possiblity of drug interactions). Add to the mix is the possibilty the pt is in an HMO or other insurance with a restricted formulary. Now the Rx you might have brought in for Avelox or Celebrex becomes a more difficult one to process. The patient has more questions and more chance for the instructions to become confused with their other medications. I hope this clarifies what goes on in this one practice setting and I look forward to working with you in the years ahead!
 
Pharmacists diagnose and treat drug related problems
Physicians diagnose and treat medical problems
(Official definitions from Wayne State University)
 
Sounds like Doug Miller!
Tha's one MAJOR aspect of a pharmacist role especially in the hospital setting. The community Rph (a good one) will also counsel PT's on their meds. Interventions made in the community are obviously different than in the hospital. A lot of patients come to the pharmacy with little knowledge about their meds, as pharmacists we can educate pt's. As the pt's become comfortable with you you will find that they usually open up and the conversation becomes very meaningful equating to a very positive intervention by increasing pt knowledge, awareness about their medicine and/or disease state that leads to greater compliance and avoid DRP's

konkan said:
Pharmacists diagnose and treat drug related problems
Physicians diagnose and treat medical problems
(Official definitions from Wayne State University)
 
A lot of good points made already. I'd like to add that the pharmacist is considered the drug expert in the process of treating a patient. MD's are very smart and have many years of schooling but I believe the Rph has a superior knowledge of pharmacodynamics/pharmacokinetics than an MD. That's not all we study but it underlies our whole education. Most Dr.'s practice in a certain area of medicine, they become very familiar and knowledgable (probably as much as a pharmacist) with a certain list of drugs. The Rph will counsel and answer questions from drugs prescribed in virtually all fields of medicine. hope that helps (We also count by fives very well!! LOL)

RonaldColeman said:
Hey, guys, serious question here. This is not a flame, but an honest query from an interested medical student. What does being a pharmacist entail? Medical doctors write prescriptions for medications, which includes dosages, durations, etc. Any time I go to the pharmacist, it just seems like he fills the prescription according to the script and that's it. I'm sure I'm missing something. What is the pharmacist's role in this process? (Let me reiterate: this is not a flame, but a genuine question.)
 
WSU2007 said:
A lot of good points made already. I'd like to add that the pharmacist is considered the drug expert in the process of treating a patient. MD's are very smart and have many years of schooling but I believe the Rph has a superior knowledge of pharmacodynamics/pharmacokinetics than an MD. That's not all we study but it underlies our whole education. Most Dr.'s practice in a certain area of medicine, they become very familiar and knowledgable (probably as much as a pharmacist) with a certain list of drugs. The Rph will counsel and answer questions from drugs prescribed in virtually all fields of medicine. hope that helps (We also count by fives very well!! LOL)

Speaking of HMOS, another minor role that the pharmacist pays attention to is helping the patient financially. If there is another drug that we believe may be cheaper and beneficial to the patient, a pharmacist may intervene. In addition to that, the pharmacist may also have to navigate the insurance a little bit. An insurance may ask the customer to pay 15 co pay whether 5 or 30 tablets so we may ask the dr to increase the prescribed amount so the patient can save a few bucks.

The difference between a clinical pharmacist and a retail pharmacist. . is the clinical part. We dont really get to see how the patient got better like a doctor or a nurse do. However a clinical pharmacist that makes his round with the doctors may.
 
RonaldColeman said:
Hey, guys, serious question here. This is not a flame, but an honest query from an interested medical student. What does being a pharmacist entail? Medical doctors write prescriptions for medications, which includes dosages, durations, etc. Any time I go to the pharmacist, it just seems like he fills the prescription according to the script and that's it. I'm sure I'm missing something. What is the pharmacist's role in this process? (Let me reiterate: this is not a flame, but a genuine question.)


Our job is to make sure that you get what the doctor wants rather than what he ordered, what the prescription said rather than what the technician typed, what the computer printed rather than what the intern pulled, what the patient needs rather than what the computer screened. All in five minutes or less.
 
baggywrinkle said:
Our job is to make sure that you get what the doctor wants rather than what he ordered, what the prescription said rather than what the technician typed, what the computer printed rather than what the intern pulled, what the patient needs rather than what the computer screened. All in five minutes or less.
LOL. Screw that. It takes as long as it takes to get it right. :p
 
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